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1
Chae, Han-Jung, Dong-Hyeon Yun, Hee-Young Chin, Sim-Keum Yoo, Hyung-Min Kim, Song-Baeg Kim, and Hyung-Ryong Kim. "Effect of Dang-Gui-Ji-Hwang-Yeum on Osteoporosis in Ovariectomized Rats." American Journal of Chinese Medicine 32, no. 03 (January 2004): 351–60. http://dx.doi.org/10.1142/s0192415x04002004.
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Dang-Gui-Ji-Hwang Yeum (DGJHY; an Oriental prescription), has been successfully used for the management of osteoporotic disorders in China, Japan and Korea. In this study, we have characterized the effect of DGJHY on osteoporosis-associated phenomena in ovariectomized (OVX) rats by measuring body weights and bone histomorphometries in sham, OVX and DGJHY-administered OVX rats. Light microscopic analyses showed a porous or an eroded appearance on the tibial trabecular bone surface in OVX rats, whereas those of the sham and DGJHY-administered OVX rats were composed of fine particles. The trabecular bone area and the trabecular thickness in OVX rats were significantly lower than those of sham rats. Moreover, these reductions in OVX rats were significantly reversed by the administration of DGJHY for 7 weeks, and osteoclast numbers were also significantly reduced. Although no differences were observed between OVX and DGJHY-administered OVX rats and the sham animals at the T 3 level, we have found significant differences between these two groups at the T 4 level. However, serum phosphorus, calcium, mechanical strength and the surface appearance of osteoblasts in the DGJHY-administered OVX rats were similar to those of OVX rats. These results suggest that DGJHY is effective at preventing bone loss in OVX rats.
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Park, In Sil, Hye Won Lee, Jin Ah Ryuk, and Byoung Seob Ko. "Effects of an Aqueous Extract of Dangguijagyagsan on Serum Lipid Levels and Blood Flow Improvement in Ovariectomized Rats." Evidence-Based Complementary and Alternative Medicine 2014 (2014): 1–8. http://dx.doi.org/10.1155/2014/497836.
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Dangguijagyagsan (DJS), a traditional herbal prescription, has long been used to treat menopause-related symptoms. We identified the cardioprotective effects of an aqueous extract of DJS using an ovariectomized (OVX) and ferric chloride- (FeCl-) induced carotid thrombosis rat model. Female Sprague-Dawley (SD) rats were ovariectomized or Sham-operated (Sham-control). The ovariectomized rats were divided into three groups: OVX with saline (OVX-control), aspirin 30 mg/kg/day (OVX-ASA), and DJS 100 mg/kg/day (OVX-DJS). The treatments were administered for 5 weeks. Then, blood samples were collected to analyze the serum lipid levels and platelet aggregation. The topical application of 40% FeCl3induced intravascular thrombosis, which was used to test thrombotic occlusion and for histological examination. Body weight and the levels of total cholesterol (TC), triglyceride (TG), and LDL-cholesterol (LDL-C) increased in the OVX rats. These effects were reduced by ASA and DJS treatment. In addition, ASA and DJS treatment significantly inhibited platelet aggregation. These treatments also increased time to occlusion and decreased both thrombus size and the presence of collagen fibers in surrounding vessel walls compared with the Sham-control and OVX-control groups. These results suggest that DJS has beneficial effects in terms of preventing cardiovascular disease in menopausal woman because it can reduce the serum lipid levels and improve blood flow by inhibiting platelet aggregation and thrombus formation.
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Crew, K. D., J. Capodice, H. Greenlee, L. Brafman, D. Fuentes, D. Awad, and D. L. Hershman. "Randomized, blinded, placebo-controlled trial of acupuncture for the management of aromatase inhibitor-associated joint symptoms in women with early-stage breast cancer." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): 571. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.571.
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571 Background: Aromatase inhibitors (AIs) have become the standard of care for the treatment of postmenopausal, hormone-sensitive breast cancer (BC). However, patients receiving AIs may experience joint symptoms which can lead to early discontinuation of this effective therapy. We examined whether acupuncture improves AI-induced arthralgias in women with early stage BC. Methods: This study is a randomized, single-blinded trial of true vs sham acupuncture twice weekly for 6 weeks in postmenopuasal women with early stage BC and self-reported musculoskeletal pain related to adjuvant AI therapy. The active intervention included full body/auricular acupuncture and a joint-specific point prescription, whereas the sham arm involved superficial needle insertion at nonacupoint locations. Outcome measures included the Brief Pain Inventory-Short Form (BPI-SF), Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC), and Modified Score for the Assessment and Quantification of Chronic Rheumatoid Affections of the Hands (M-SACRAH) obtained at baseline, 3 and 6 weeks. Lower scores reflect improvement in symptoms. Results: Of 43 women enrolled, 38 were evaluable at 6 weeks. Baseline characteristics were comparable between the groups. Median age: 57 (37–77); White/Hispanic/Black/Asian: 15/21/1/1; median body mass index (kg/m2): 29 (18–45). True acupuncture was associated with about a 50% decrease in mean BPI-SF scores, whereas no change from baseline was observed for the sham acupuncture group (see table). Similar findings were seen for the WOMAC and M-SACRAH pain, stiffness, and function scores (P<0.05). No adverse events were reported. Conclusions: Women with AI-induced arthralgias treated with acupuncture had significant improvement of joint pain and stiffness, which was not seen with sham acupuncture. Acupuncture is an effective and well-tolerated strategy for managing this common treatment-related side effect. [Table: see text] No significant financial relationships to disclose.
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Radavi-Asgar, Maryam, Nazanin Sabet, Mohammad Khaksari, Elham Jafari, Zahra Soltani, and Fatemeh Dehghanian. "The Prescription of Oral Mucosal Mesenchymal Stem Cells post-Traumatic Brain Injury Improved the Kidney and Heart Inflammation and Oxidative Stress." BioMed Research International 2022 (November 10, 2022): 1–12. http://dx.doi.org/10.1155/2022/8235961.
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Background. In the last years, mesenchymal stem cells (MSCs) have been considered as a useful strategy to treat many diseases such as traumatic brain injury (TBI). The production of inflammatory agents by TBI elicits an inflammatory response directed to other systems of body, such as the heart and the kidneys. In this study, the efficacy of oral mucosal mesenchymal stem cells (OMSCs) prescription after TBI in inflammation and oxidative stress of the heart and kidneys was evaluated. Methods. Twenty-four male rats were located in groups as follows: sham, TBI, vehicle (Veh), and stem cell (SC). OMSCs were injected intravenously 1 and 24 hours after TBI. Inflammatory, oxidative stress, and histopathological outcomes of the heart and kidney tissues were investigated 48 hours after TBI. Results. TBI caused an increase in the level of interleukin-1β (IL-1β), interleukin-6 (IL-6), malondialdehyde (MDA), and carbonyl protein (PC) of the heart and kidney compared to the sham group. Superoxide dismutase (SOD), total antioxidant capacity (TAC), catalase (CAT), and interleukin-10 (IL-10) of the heart and kidney decreased after TBI. The use of OMSCs after TBI reduced the changes of these factors in both the heart and the kidney. Conclusion. Application of OMSCs after TBI can decrease inflammation and oxidative stress of the heart and kidney tissues leading to the reduction of damage. Therefore, this method can be evaluated in the TBI patients in future studies.
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Siemens, Waldemar, Christopher Boehlke, Michael I. Bennett, Klaus Offner, Gerhild Becker, and Jan Gaertner. "Transcutaneous electrical nerve stimulation for advanced cancer pain inpatients in specialist palliative care—a blinded, randomized, sham-controlled pilot cross-over trial." Supportive Care in Cancer 28, no. 11 (March 3, 2020): 5323–33. http://dx.doi.org/10.1007/s00520-020-05370-8.
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Abstract Purpose Transcutaneous electrical nerve stimulation (TENS) is a treatment option for cancer pain, but the evidence is inconclusive. We aimed to evaluate the efficacy and safety of TENS. Methods A blinded, randomized, sham-controlled pilot cross-over trial (NCT02655289) was conducted on an inpatient specialist palliative care ward. We included adult inpatients with cancer pain ≥ 3 on an 11-point numerical rating scale (NRS). Intensity-modulated high TENS (IMT) was compared with placebo TENS (PBT). Patients used both modes according to their preferred application scheme during 24 h with a 24-h washout phase. The primary outcome was change in average pain intensity on the NRS during the preceding 24 h. Responders were patients with at least a “slight improvement.” Results Of 632 patients screened, 25 were randomized (sequence IMT-PBT = 13 and PBT-IMT = 12). Finally, 11 patients in IMT-PBT and 9 in PBT-IMT completed the study (N = 20). The primary outcome did not differ between groups (IMT minus PBT: − 0.2, 95% confidence interval − 0.9 to 0.6). However, responder rates were higher in IMT (17/20 [85%] vs. 10/20 [50%], p = 0.0428). Two patients experienced an uncomfortable feeling caused by the current, one after IMT and one after PBT. Seven patients (35%) desired a TENS prescription. Women and patients with incident pain were most likely to benefit from TENS. Conclusion TENS was safe, but IMT was unlikely to offer more analgesic effects than PBT. Even though many patients desired a TENS prescription, 50% still reported at least “slight pain relief” from PBT. Differences for gender and incident pain aspects demand future trials.
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Lan, Rui, Jun Xiang, Guo-Hua Wang, Wen-Wei Li, Wen Zhang, Li-Li Xu, and Ding-Fang Cai. "Xiao-Xu-MingDecoction Protects against Blood-Brain Barrier Disruption and Neurological Injury Induced by Cerebral Ischemia and Reperfusion in Rats." Evidence-Based Complementary and Alternative Medicine 2013 (2013): 1–12. http://dx.doi.org/10.1155/2013/629782.
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Xiao-Xu-Mingdecoction (XXMD) is an effective prescription in the treatment of ischemic stroke, but the mechanisms involved are not well known. In the present study, 120 male Sprague-Dawley rats were randomly divided into 5 groups: sham control (sham), ischemia and reperfusion (IR), and IR plus 15, 30, and 60 g/kg/day XXMD. The stroke model was induced by 90 min of middle cerebral artery occlusion followed by reperfusion. The brain lesion areas were evaluated by 2,3,5-triphenyltetrazolium chloride staining, and neurological deficits were observed at different time points after reperfusion. Blood-brain barrier (BBB) disruption was evaluated by assessing brain water content and Evans blue content. Pathological changes in BBB ultrastructure were observed with transmission electron microscopy. MMP-9, -2, and VEGF expression levels were quantitatively determined by western blotting and immunohistochemistry. We found that XXMD (60 g/kg/day) treatment reduced cerebral infarct area, improved behavioral function, and attenuated ultrastructure damage and permeability of BBB following ischemia and reperfusion. Moreover, XXMD downregulated the expression levels of MMP-9, -2, and VEGF. These findings indicate that XXMD alleviates BBB disruption and cerebral ischemic injury, which may be achieved by inhibiting the expression of MMP-9, -2, and VEGF.
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Bai, Wen-Wu, Yi-Fan Xing, Bo Wang, Xiao-Ting Lu, Ying-Bin Wang, Yuan-Yuan Sun, Xiao-Qiong Liu, Tao Guo, and Yu-Xia Zhao. "Tongxinluo Improves Cardiac Function and Ameliorates Ventricular Remodeling in Mice Model of Myocardial Infarction through Enhancing Angiogenesis." Evidence-Based Complementary and Alternative Medicine 2013 (2013): 1–9. http://dx.doi.org/10.1155/2013/813247.
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Background. Myocardial infarction (MI) is a major cause of morbidity and mortality in the world. Tongxinluo (TXL) is a traditional Chinese compound prescription which has cardioprotective functions. The present study was aimed to determine the effect of TXL on postischemic cardiac dysfunction and cardiac remodeling and to elucidate the underlying mechanisms.Methods and Results. MI was performed by ligation of left anterior descending coronary artery (LAD) in male adult mice. Mice were randomly divided into four groups: (1) sham group (Sham); (2) MI-control group (Control); (3) MI-low dose TXL group (TXL-L); and (4) MI-high dose TXL (TXL-H) group. Compared with the control group, TXL treatment restored cardiac function, increased revascularization, attenuated cardiomyocyte apoptosis, and reduced interstitial fibrosis. TXL treatment increased the phosphorylation of Akt, extracellular signal regulated kinase (ERK), and endothelial nitric oxide synthase (eNOS); the expression of phosphatidylinositol3-kinase (PI3K), hypoxia-inducible factors 1α(HIF-1α), and vascular endothelial growth factor (VEGF); and the DNA binding activity of HIF-1αafter MI.Conclusion. TXL may improve cardiac function and ameliorate cardiac remodeling by increasing neovascularization through enhancing the phosphorylation of Akt and ERK, the expression and activity of HIF-1α, and the protein level of VEGF and p-eNOS.
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Vasconcelos-Filho, Francisco S. L., Roberta C. da Rocha-e-Silva, Jonathan E. R. Martins, Welton D. N. Godinho, Vitor V. da Costa, Jannison K. C. Ribeiro, Carlos A. da Silva, Vania M. Ceccatto, Paula M. Soares, and Janaina S. A. M. Evangelista. "Neuroprotector Effect of Daily 8-Minutes of High-Intensity Interval Training in Rat Aβ1-42 Alzheimer Disease Model." Current Alzheimer Research 17, no. 14 (March 5, 2021): 1320–33. http://dx.doi.org/10.2174/1567205018666210218161856.
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Background: Alzheimer’s disease (AD) is the most common and irreversible neurodegenerative disorder, and amyloid peptide plays a central role in its pathogenesis. Physical training contributes as a beneficial adaptation to AD. However, these effects may be underestimated because much of the literature used fixed training prescription variables (intensity and volume) throughout the protocol. Moreover, researchers poorly understand whether chronic high-intensity interval training (HIIT) exerts similar effects on the brain tissue of individuals with AD. Objective: This study evaluated the effect of 8 minutes of HIIT with incremental overload in an AD model. Methods: Forty male Wistar rats were divided into four groups: an untrained Sham group, Sham trained group, Aβ1-42 (Alzheimer’s) untrained group, and Aβ1-42 (Alzheimer’s) trained group (n=10 rats per group). Animals underwent stereotactic surgery and received a hippocampal injection of Aβ1-42 or a saline solution. Seven days after surgery, two weeks of treadmill adaptation followed by a maximal running test (MRT) was performed. Then, animals were subjected to eight weeks of HIIT. Rats were sacrificed 24 h after the behavioral tests (open field and Morris water maze), hippocampal tissue was extracted to analyze the redox balance and BDNF/TrkB pathway, and neuritic plaques (NP) were detected by evaluating silver impregnation. Results: The AD trained group presented a physical capacity amelioration every two weeks and locomotor, learning, and memory improvements (p<0.05). These effects were accompanied by increased CAT and SOD levels, followed by decreased lipid peroxidation (p<0.05). Furthermore, increased activation of the BDNF/TrkB (p<0.05) pathway and decreased NP was observed. Conclusions: Based on these results, MRT was essential for an excellent chronic training protocol prescription and overload adjustment. Therefore, 8 minutes of HIIT daily for 8 weeks may reduce behavioral deficits by promoting a positive redox balance and increased activity of the BDNF/TrkB pathway that may contribute to NP attenuation.
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Lee, Subum, Dae-Chul Cho, Kyong-Tae Kim, and Young-Seok Lee. "Evidence-based treatment of osteoporotic vertebral compression fracture." Journal of the Korean Medical Association 64, no. 3 (March 10, 2021): 200–207. http://dx.doi.org/10.5124/jkma.2021.64.3.200.
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The prevalence and medical costs of osteoporotic vertebral compression fractures (OVCFs) are on the rise. However, a concrete evidence-based treatment guideline has not yet been established. Despite that numerous randomized controlled trials (RCTs) were performed, the study design and outcome measurement were heterogeneous, and the results were not unified. The purpose of this review is to compare the results of high level-evidence studies to provide a background for evidence-based OVCF treatment. Many reports showed that vertebroplasty has better clinical outcomes than non-surgical treatment for OVCF, but the results of three double-blinded RCTs with the highest level of evidence did not show a significant difference between vertebroplasty and sham procedure. Whether undergoing surgical or non-surgical treatment, OVCF patient management should be started by managing osteoporosis first. Meanwhile, in the results of RCTs related to the comparison of conservative treatment modalities, the benefit of braces and a specific analgesic prescription protocol was also unclear. The presented results of each clinical trial were generally inconsistent and may not be appropriate in all situations. Any decision by clinicians to apply this evidence must be made considering individual patients and available resources. At present, controversy remains about the best treatment modality for OVCF. Large, multicenter, placebo/sham-controlled trials are needed to address this gap and establish strong evidence-based guidelines.
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Zhang, Meng-yun, Hui-hua Chen, Jing Tian, Hui-juan Chen, Ling-ling Zhu, Pei Zhao, and Ting Zhang. "Danggui Shaoyao San Ameliorates Renal Fibrosis via Regulation of Hypoxia and Autophagy." Evidence-Based Complementary and Alternative Medicine 2019 (March 17, 2019): 1–10. http://dx.doi.org/10.1155/2019/2985270.
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Danggui Shaoyao San (DSS), a traditional Chinese medicinal prescription, was widely used to reinforce earth to activate collaterals in ancient times. Recently, many clinical studies found that DSS had a renoprotection. In this study, we evaluated the effect of DSS on unilateral ureteral obstruction- (UUO-) induced renal fibrosis in rats and investigated the mechanisms underlying the effect. Sprague Dawley (SD) rats were randomized to UUO or Sham operation. After 1 day, the rats that underwent UUO were randomized to treatment for four experimental groups (n=10 each group): Sham, UUO only, UUO+ benazepril (Bena), and UUO+DSS. After 4 weeks, we demonstrated that DSS significantly suppressed UUO-induced renal hypertrophy by gravimetric. In addition, DSS obviously prevented UUO-induced disorder in renal structure and renal function by HE and biochemistry test. We also found that DSS abrogated UUO-induced renal fibrosis by Masson’s staining and collagen volume fraction (CVF) analysis; this is consistent with the western blot analysis that showed DSS abrogated the UUO-induced enhanced TGF-β1 and weakened BMP-7. Compared with the UUO only group, rats treated with DSS exhibited significant increase in vascular density, followed by decrease in hypoxia and HIF-1α protein level through western blot and immunofluorescence analysis. Furthermore, we also determined proteins of autophagy and DSS enhanced autophagy to prevent the damage-induced by UUO. Taken together, our findings demonstrated that DSS had a renoprotection effect in ameliorating renal fibrosis possibly via attenuating tissue hypoxia and regulating autophagy.
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Garcia, Laura M., Brandon J. Birckhead, Parthasarathy Krishnamurthy, Josh Sackman, Ian G. Mackey, Robert G. Louis, Vafi Salmasi, Todd Maddox, and Beth D. Darnall. "An 8-Week Self-Administered At-Home Behavioral Skills-Based Virtual Reality Program for Chronic Low Back Pain: Double-Blind, Randomized, Placebo-Controlled Trial Conducted During COVID-19." Journal of Medical Internet Research 23, no. 2 (February 22, 2021): e26292. http://dx.doi.org/10.2196/26292.
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Background Chronic low back pain is the most prevalent chronic pain condition worldwide and access to behavioral pain treatment is limited. Virtual reality (VR) is an immersive technology that may provide effective behavioral therapeutics for chronic pain. Objective We aimed to conduct a double-blind, parallel-arm, single-cohort, remote, randomized placebo-controlled trial for a self-administered behavioral skills-based VR program in community-based individuals with self-reported chronic low back pain during the COVID-19 pandemic. Methods A national online convenience sample of individuals with self-reported nonmalignant low back pain with duration of 6 months or more and with average pain intensity of 4 or more/10 was enrolled and randomized 1:1 to 1 of 2 daily (56-day) VR programs: (1) EaseVRx (immersive pain relief skills VR program); or (2) Sham VR (2D nature content delivered in a VR headset). Objective device use data and self-reported data were collected. The primary outcomes were the between-group effect of EaseVRx versus Sham VR across time points, and the between–within interaction effect representing the change in average pain intensity and pain-related interference with activity, stress, mood, and sleep over time (baseline to end-of-treatment at day 56). Secondary outcomes were global impression of change and change in physical function, sleep disturbance, pain self-efficacy, pain catastrophizing, pain acceptance, pain medication use, and user satisfaction. Analytic methods included intention-to-treat and a mixed-model framework. Results The study sample was 179 adults (female: 76.5%, 137/179; Caucasian: 90.5%, 162/179; at least some college education: 91.1%, 163/179; mean age: 51.5 years [SD 13.1]; average pain intensity: 5/10 [SD 1.2]; back pain duration ≥5 years: 67%, 120/179). No group differences were found for any baseline variable or treatment engagement. User satisfaction ratings were higher for EaseVRx versus Sham VR (P<.001). For the between-groups factor, EaseVRx was superior to Sham VR for all primary outcomes (highest P value=.009), and between-groups Cohen d effect sizes ranged from 0.40 to 0.49, indicating superiority was moderately clinically meaningful. For EaseVRx, large pre–post effect sizes ranged from 1.17 to 1.3 and met moderate to substantial clinical importance for reduced pain intensity and pain-related interference with activity, mood, and stress. Between-group comparisons for Physical Function and Sleep Disturbance showed superiority for the EaseVRx group versus the Sham VR group (P=.022 and .013, respectively). Pain catastrophizing, pain self-efficacy, pain acceptance, prescription opioid use (morphine milligram equivalent) did not reach statistical significance for either group. Use of over-the-counter analgesic use was reduced for EaseVRx (P<.01) but not for Sham VR. Conclusions EaseVRx had high user satisfaction and superior and clinically meaningful symptom reduction for average pain intensity and pain-related interference with activity, mood, and stress compared to sham VR. Additional research is needed to determine durability of treatment effects and to characterize mechanisms of treatment effects. Home-based VR may expand access to effective and on-demand nonpharmacologic treatment for chronic low back pain. Trial Registration ClinicalTrials.gov NCT04415177; https://clinicaltrials.gov/ct2/show/NCT04415177 International Registered Report Identifier (IRRID) RR2-10.2196/25291
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Zhu, Jia-Zhen, Xiao-Yi Bao, Qun Zheng, Qiang Tong, Peng-Chong Zhu, Zhuang Zhuang, and Yan Wang. "Buyang Huanwu Decoction Exerts Cardioprotective Effects through Targeting Angiogenesis via Caveolin-1/VEGF Signaling Pathway in Mice with Acute Myocardial Infarction." Oxidative Medicine and Cellular Longevity 2019 (April 16, 2019): 1–15. http://dx.doi.org/10.1155/2019/4275984.
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Background. Acute myocardial infarction (AMI) remains a leading cause of morbidity and mortality worldwide. The idea of therapeutic angiogenesis in ischemic myocardium is a promising strategy for MI patients. Buyang Huanwu decoction (BHD), a famous Chinese herbal prescription, exerted antioxidant, antiapoptotic, and anti-inflammatory effects, which contribute to cardio-/cerebral protection. Here, we aim to investigate the effects of BHD on angiogenesis through the caveolin-1 (Cav-1)/vascular endothelial growth factor (VEGF) pathway in MI model of mice. Materials and Methods. C57BL/6 mice were randomly divided into 3 groups by the table of random number: (1) sham-operated group (sham, n=15), (2) AMI group (AMI+sham, n=20), and (3) BHD-treated group (AMI+BHD, n=20). 2,3,5-Triphenyltetrazolium chloride solution stain was used to determine myocardial infarct size. Myocardial histopathology was tested using Masson staining and hematoxylin-eosin staining. CD31 immunofluorescence staining was used to analyze the angiogenesis in the infarction border zone. Western blot analysis, immunofluorescence staining, and/or real-time quantitative reverse transcription polymerase chain reaction was applied to test the expression of Cav-1, VEGF, vascular endothelial growth factor receptor 2 (VEGFR2), and/or phosphorylated extracellular signal-regulated kinase (p-ERK). All statistical analyses were performed using the SPSS 20.0 software and GraphPad Prism 6.05. Values of P<0.05 were considered as statistically significant. Results and Conclusion. Compared with the AMI group, the BHD-treated group showed a significant improvement in the heart weight/body weight ratio, echocardiography images, cardiac function, infarct size, Mason staining of the collagen deposition area, and density of microvessel in the infarction border zone (P<0.05). Compared with the AMI group, BHD promoted the expression of Cav-1, VEGF, VEGFR2, and p-ERK in the infarction border zone after AMI. BHD could exert cardioprotective effects on the mouse model with AMI through targeting angiogenesis via Cav-1/VEGF signaling pathway.
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Cheng, Hongfa, Yawen Zhang, Xiaoyao Guo, Xuan Wang, Hanyu Wang, Hui Zhao, Lei Wang, Haiyan Zou, and Qiuxia Zhang. "Study on Neuroprotective Mechanism of Houshiheisan in Ischemic Stroke Based on Transcriptomics and Experimental Verification." Evidence-Based Complementary and Alternative Medicine 2023 (February 6, 2023): 1–12. http://dx.doi.org/10.1155/2023/8673136.
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Houshiheisan (HSHS), a classic prescription in traditional Chinese medicine (TCM), has shown outstanding efficacy in treating stroke. This study investigated various therapeutic targets of HSHS for ischemic stroke using mRNA transcriptomics. Herein, rats were randomly separated into the sham, model, HSHS 5.25 g/kg (HSHS5.25), and HSHS 10.5 g/kg (HSHS10.5) groups. Rats suffering from stroke were induced by permanent middle cerebral artery occlusion (pMCAO). After seven days of HSHS treatment, behavioral tests were conducted, and histological damage was examined with hematoxylin-eosin (HE). The mRNA expression profiles were identified using microarray analysis and quantitative real-time PCR (qRT-PCR) validated gene expression changes. An analysis of gene ontology and pathway enrichment was conducted to analyze potential mechanisms confirmed using immunofluorescence and western blotting. HSHS5.25 and HSHS10.5 improved neurological deficits and pathological injury in pMCAO rats. The intersections of 666 differentially expressed genes (DEGs) were chosen using transcriptomics analysis in the sham, model, and HSHS10.5 groups. The enrichment analysis suggested that the therapeutic targets of HSHS might regulate the apoptotic process and ERK1/2 signaling pathway, which was related to neuronal survival. Moreover, TUNEL and immunofluorescence analysis indicated that HSHS inhibited apoptosis and enhanced neuronal survival in the ischemic lesion. Western blot and immunofluorescence assay indicated that HSHS10.5 decreased Bax/Bcl-2 ratio and suppressed caspase-3 activation, while the phosphorylation of ERK1/2 and CREB was upregulated in a stroke rat model after HSHS treatment. Effective inhibition of neuronal apoptosis by activating the ERK1/2-CREB signaling pathway may be a potential mechanism for HSHS in the treatment of ischemic stroke.
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Li, P., and S. X. Liu. "Effects of Shugan-Liangxue prescription combined with anastrozole (ANA) on bone metabolism of ovariectomy (OVX) rats." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): e11551-e11551. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.e11551.
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e11551 Background: A randomized double-blind clinical trial has confirmed traditional Chinese medicine (TCM) Shugan-Liangxue prescription could relieve hot flashes in breast cancer with endocrine therapy. The purpose of this study was to observe the effects of TCM combined with ANA on serum estradiol (E2 ) level and bone metabolism. Methods: The postmenopausal animal model was successful after OVX and testified by vaginal smear method. Sixty 6-month SD rats were randomly divided into control, TCM, ANA, ANA+TCM, alendronate sodium (AL), and sham groups. After 16 weeks intragastric administration, the bone mineral density (BMD) of femur and lumbar vertebra were measured by dual energy X-ray absorptiometry. The serum E2, osteocalcin (BGP), and prostaglandin E2 (PGE2) were detected by radioimmunoassay and pyridinoline (PYD) was by ELISA. Results: Serum E2 level decreased in TCM, ANA, and ANA+TCM groups compared with the control (P<0.05, P<0.01, P<0.001), BMD had no significant difference compared with the control. In ANA+TCM group, BGP (bone formation index) increased, PYD (bone absorption index) and PGE2 declined significantly compared with ANA group (P<0.05, P<0.05, P<0.01). PYD decreased greatly in TCM and AL groups compared with the control (P<0.001, P<0.001). Conclusions: TCM combined with ANA decreased serum E2 level, but did not decline BMD of OVX rats. It could also elevate BGP and decrease PYD level in serum. It was possible that TCM combined with ANA could alleviate musculoskeletal pain through PGE2 decrease. The effect of TCM reducing PYD was similar with AL. [Table: see text] No significant financial relationships to disclose.
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Chu, Shuang, Li Wang, Xiao-dong Mao, and Wen Peng. "Improvement of Huangqi Decoction on Endothelial Dysfunction in 5/6 Nephrectomized Rats." Cellular Physiology and Biochemistry 40, no. 6 (2016): 1354–66. http://dx.doi.org/10.1159/000453188.
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Background/Aims: Endothelial dysfunction is a major factor in the progression of chronic kidney disease, which correlates with oxidative stress and NO deficiency. Huangqi decoction (HQD) is a potential anti-oxidant ingredient in renoprotection. However, the underlying mechanisms remained identified. Therefore, we investigated whether HQD exhibit improvement in endothelial dysfunction in the 5/6 nephrectomy (Nx) rat model. Methods: Male Wistar rats (180 - 250 g) were divided into sham, Nx and Nx + HQD (0.05, 0.15 and 0.45 g/kg) group, respectively. Renal function and histology were examined with ELISA and Immunohistochemical analysis. Endothelium-dependent relaxation of rat aortas was investigated by isometric tension recordings. Oxidative stress and NO bioavailability were detected by ELISA, DHE-staining, DAF-2 staining and western blotting. Results: Compared with Nx rats, HQD treatment reversed the functional and structural changes of kidney significantly. Besides, endothelium-dependent relaxation of rat aortas was also improved by HQD treatment. NADPH oxidase and ROS generation were inhibited while NO bioavailability was enhanced. Conclusion: HQD can act as a potent prescription for the treatment of endothelium related vascular complications.
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Song, Yi, Yi Wang, Xin Qi, Xin Kang, and Xiaoguang Lu. "Da-Huang-Fu-Zi-Tang Ameliorates Severe Acute Pancreatitis by Elevation of M2 Kupffer Cells in Rats." Evidence-Based Complementary and Alternative Medicine 2021 (June 2, 2021): 1–8. http://dx.doi.org/10.1155/2021/5561216.
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Introduction. Severe acute pancreatitis (SAP) is a clinical emergency often accompanied by inflammatory response syndrome (SIRS), which eventually leads to acute lung injury and failure of other organs. The activation of liver Kupffer cells (KCs) plays a major role in the process of SIRS and multiorgan damage caused by SAP. Da-Huang-Fu-Zi-Tang (DHFZT), a traditional Chinese prescription, has been widely used for SAP in the clinic. The present study investigated the activation state of KCs in SAP and the potential mechanism of DHFZT. Methods. A total of 24 Sprague Dawley rats were randomly assigned to four groups: SH (sham operation group + saline enema), SH-DHFZT (sham operation group + DHFZT enema), SAP (model group + saline enema), and SAP-DHFZT (model group + DHFZT enema). Blood samples were drawn from the abdominal aorta for measuring serum endotoxin, amylase, calcium ion, IL-1β, TNF-α, iNOS, and IL-10. Then, the pancreas, lung, liver, and ileum were harvested for histological observation, and the liver was used to detect the level of F4/80, CD86, and CD163 in KCs with immunohistochemistry and western blot. Results. In the SAP group, the CD86+ KCs were significantly increased with a high level of IL-1β, TNF-α, and iNOS, and the organs were impaired. In the SAP-DHFZT group, CD163+ KCs were significantly increased with the high level of IL-10, and the damage to organs was alleviated. Conclusion. These phenomena suggested that the SIRS and multiple organ damage in SAP might be related to the excessive activation of M1 KCs, and DHFZT might alleviate the SIRS by inducing the differentiation of KCs into the M2-type and promote the expression of anti-inflammatory factor IL-10.
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Loan, Huỳnh Thị, Lam Minh Yen, Evelyne Kestelyn:, Nguyen Van Hao, Tran Tan Thanh, Nguyen Thi Phuong Dung, Hugo C. Turner, et al. "Intrathecal Immunoglobulin for treatment of adult patients with tetanus: A randomized controlled 2x2 factorial trial." Wellcome Open Research 3 (May 16, 2018): 58. http://dx.doi.org/10.12688/wellcomeopenres.14587.1.
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Despite long-standing availability of an effective vaccine, tetanus remains a significant problem in many countries. Outcome depends on access to mechanical ventilation and intensive care facilities and in settings where these are limited, mortality remains high. Administration of tetanus antitoxin by the intramuscular route is recommended treatment for tetanus, but as the tetanus toxin acts within the central nervous system, it has been suggested that intrathecal administration of antitoxin may be beneficial. Previous studies have indicated benefit, but with the exception of one small trial no blinded studies have been performed. The objective of this study is to establish whether the addition of intrathecal tetanus antitoxin reduces the need for mechanical ventilation in patients with tetanus. Secondary objectives: to determine whether the addition of intrathecal tetanus antitoxin reduces autonomic nervous system dysfunction and length of hospital/ intensive care unit stay; whether the addition of intrathecal tetanus antitoxin in the treatment of tetanus is safe and cost-effective; to provide data to inform recommendation of human rather than equine antitoxin. This study will enroll adult patients (≥16 years old) with tetanus admitted to the Hospital for Tropical Diseases, Ho Chi Minh City. The study is a 2x2 factorial blinded randomized controlled trial. Eligible patients will be randomized in a 1:1:1:1 manner to the four treatment arms (intrathecal treatment and human intramuscular treatment, intrathecal treatment and equine intramuscular treatment, sham procedure and human intramuscular treatment, sham procedure and equine intramuscular treatment). Primary outcome measure will be requirement for mechanical ventilation. Secondary outcome measures: duration of hospital/ intensive care unit stay, duration of mechanical ventilation, in-hospital and 240-day mortality and disability, new antibiotic prescription, incidence of ventilator associated pneumonia and autonomic nervous system dysfunction, total dose of benzodiazepines and pipecuronium, and incidence of adverse events. Trial registration: ClinicalTrials.gov NCT02999815 Registration date: 21 December 2016
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Loan, Huỳnh Thị, Lam Minh Yen, Evelyne Kestelyn:, Nguyen Van Hao, Tran Tan Thanh, Nguyen Thi Phuong Dung, Hugo C. Turner, et al. "Intrathecal Immunoglobulin for treatment of adult patients with tetanus: A randomized controlled 2x2 factorial trial." Wellcome Open Research 3 (November 5, 2018): 58. http://dx.doi.org/10.12688/wellcomeopenres.14587.2.
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Despite long-standing availability of an effective vaccine, tetanus remains a significant problem in many countries. Outcome depends on access to mechanical ventilation and intensive care facilities and in settings where these are limited, mortality remains high. Administration of tetanus antitoxin by the intramuscular route is recommended treatment for tetanus, but as the tetanus toxin acts within the central nervous system, it has been suggested that intrathecal administration of antitoxin may be beneficial. Previous studies have indicated benefit, but with the exception of one small trial no blinded studies have been performed. The objective of this study is to establish whether the addition of intrathecal tetanus antitoxin reduces the need for mechanical ventilation in patients with tetanus. Secondary objectives: to determine whether the addition of intrathecal tetanus antitoxin reduces autonomic nervous system dysfunction and length of hospital/ intensive care unit stay; whether the addition of intrathecal tetanus antitoxin in the treatment of tetanus is safe and cost-effective; to provide data to inform recommendation of human rather than equine antitoxin. This study will enroll adult patients (≥16 years old) with tetanus admitted to the Hospital for Tropical Diseases, Ho Chi Minh City. The study is a 2x2 factorial blinded randomized controlled trial. Eligible patients will be randomized in a 1:1:1:1 manner to the four treatment arms (intrathecal treatment and human intramuscular treatment, intrathecal treatment and equine intramuscular treatment, sham procedure and human intramuscular treatment, sham procedure and equine intramuscular treatment). Primary outcome measure will be requirement for mechanical ventilation. Secondary outcome measures: duration of hospital/ intensive care unit stay, duration of mechanical ventilation, in-hospital and 240-day mortality and disability, new antibiotic prescription, incidence of ventilator associated pneumonia and autonomic nervous system dysfunction, total dose of benzodiazepines and pipecuronium, and incidence of adverse events. Trial registration: ClinicalTrials.gov NCT02999815 Registration date: 21 December 2016
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Persu, Alexandre, Fadl Elmula M. Fadl Elmula, Yu Jin, Ingrid Os, Sverre E. Kjeldsen, and Jan A. Staessen. "Renal Denervation After Symplicity HTN-3 – Back to Basics. Review of the Evidence." European Cardiology Review 9, no. 2 (2014): 110. http://dx.doi.org/10.15420/ecr.2014.9.2.110.
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Renal sympathetic denervation (RDN) has been proposed as a new treatment modality in patients with apparent treatment resistant hypertension, a condition defined as office blood pressure elevation despite prescription of at least three antihypertensive drugs including a diuretic. However, the impressive fall in blood pressure reported after RDN in Symplicity HTN-2, the first randomised study, and multiple observational studies has not been confirmed in the US sham-controlled trial Symplicity HTN-3 and four subsequent prospective randomised studies, all published or presented in 2014. The blood pressure reduction documented in earlier studies may be largely due to non-specific effects such as improvement of drug adherence in initially poorly adherent patients (Hawthorne effect), placebo effect and regression to the mean. The overall blood pressure lowering effect of RDN seems rather limited and the characteristics of true responders remain largely unknown. Accordingly, RDN is not ready for clinical practice. In most patients with apparent drug-resistant hypertension, drug monitoring and subsequent improvement of drug adherence may prove more effective and cost-beneficial to achieve blood pressure control. In the meantime, research should aim at identifying characteristics of those few patients adherent to drug treatment and with true resistant hypertension who may respond to RDN.
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Sun, Juan, Najina Wugeti, and Aliman Mahemuti. "Reversal effect of Zhigancao decoction on myocardial fibrosis in a rapid pacing-induced atrial fibrillation model in New Zealand rabbits." Journal of International Medical Research 47, no. 2 (January 11, 2019): 884–92. http://dx.doi.org/10.1177/0300060518799819.
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Objective To evaluate the effect of Zhigancao decoction on reversal of right atrial myocardial fibrosis after rapid atrial pacing (RAP)-induced atrial fibrillation (AF). Methods New Zealand white rabbits were randomly divided into four groups: sham operation group (Group A: implanted electrodes, no RAP), pacing group (Group B: RAP-induced AF), Zhigancao soup water decoction Yin group (Group C: RAP-induced AF followed by Zhigancao soup Yin prescription twice a day for 30 days), and Zhigancao soup group (Group D: RAP-induced AF followed by Zhigancao water decoction twice a day for 30 days). The atrial myocardium was then examined for myocardial fibrosis by Masson staining, and protein expression of matrix metalloproteinase-9 (MMP-9) was immunohistochemically assessed. The right atrial appendage tissue field action potential duration (fAPD) was measured by microelectrode arrays. Results RAP successfully induced AF. Myocardial fibrosis was more severe in Groups B and C and less severe in Group D. Protein expression of MMP-9 was strongly positive in Groups B and C and weakly positive in Group D. The fAPD was significantly decreased in Groups B and C, but the decrease in Group D was not significant. Conclusion Zhigancao decoction can reverse AF-induced myocardial fibrosis in rabbits and shorten the fAPD.
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Li, Zhijie, Qing Tong, Huifang Xu, Li Hu, Rong Zhao, Fang Zhou, Wei Pan, and Li Zhou. "Therapeutic Effects of TianDiJingWan on the Aβ25–35-Induced Alzheimer’s Disease Model Rats." Evidence-Based Complementary and Alternative Medicine 2015 (2015): 1–9. http://dx.doi.org/10.1155/2015/307350.
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The main purpose of this study was to demonstrate the therapeutic effects and mechanism of TDJW, a modern Chinese medicine prescription developed based on the basic traditional Chinese medicine theory of “tonifying the kidney essence,” on the Aβ25–35-induced AD rats. The AD model was established by the intracerebroventricular administrations of Aβ25–35into the hippocampus CA1 tissue of SD male rats. 72 rats were randomly divided into six groups: sham operation, AD model, donepezil, high TDJW group, medium TDJW group, and low TDJW group. After oral administration of TDJW, the results of Morris water maze and step-down test showed that the learning and memory abilities of AD rats were significantly improved. And biochemical measurement demonstrated that Ach and Glu in hippocampus tissues of AD rats were increased as well. Moreover, the Aβdeposits and p-Tau aggregations in hippocampus CA1 tissues of AD rats were attenuated as observed in the micrographs of immunohistochemistry study, and the results of ELISA indicated that the expressions of TNF-α, IL-1β, and IL-6 in hippocampus tissues were significantly decreased. In conclusion, the present study demonstrated that TDJW could be used as a promising therapeutic agent for the clinical applications of AD treatment in patients.
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Liang, Yuan, Xiao-Ling Guo, Jia-Xu Chen, and Guang-Xin Yue. "Effects of the Chinese Traditional Prescription Xiaoyaosan Decoction on Chronic Immobilization Stress-Induced Changes in Behavior and Ultrastructure in Rat Hippocampus." Evidence-Based Complementary and Alternative Medicine 2013 (2013): 1–8. http://dx.doi.org/10.1155/2013/984797.
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Xiaoyaosan (XYS) decoction has been widely used as a traditional medicine for treating stress and depression-related disorders in China for thousands of years.Aim of the Study. To observe the potential mechanism of XYS decoction’s antidepressant-like effect inα-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors related to synaptic plasticity in the hippocampus rats induced by chronic immobilization stress (CIS).Materials and Methods. Animals were randomly divided into five groups: (1) control group; (2) sham-operated group; (3) CIS group, in which rats were conducted CIS for 21 days; (4) XYS decoction treatment group; (5) 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX) positive group, in which the amygdala of CIS rats was unilaterally microinjected with a competitive glutamate receptor antagonist, CNQX. After CIS for 21 days, the open field test (OPT) and elevated plus-maze test (EPM) were measured, the ultrastructure of hippocampus CA1subregion was observed by the electron microscopy; both the GluR1 and GluR2 mRNA level of AMPA receptor subunits in hippocampus CA1subregion were detected by real-time qPCR.Results. Rats subjected to CIS exhibited increases in time in central zone and decreases in total distance traveled in the OPT. In the EPM, they also showed decreases in center zone time and entries, open arm time and entries, and an increase in close arm time. Ultrastructural damage in the hippocampus CA1was also observed. XYS decoction and CNQX showed significant improvement behavioral changes and the ultrastructural damage of the hippocampus CA1; XYS decoction also reversed CIS-induced decreases in GluR2 mRNA and increases in GluR1 mRNA in the hippocampus CA1as well as CNQX.Conclusions. XYS decoction may effectively produce an antidepressant-like effect, which appears to be involved AMPA receptors related synaptic plasticity of hippocampus.
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Wang, Meng, Jing Yang, Yuan Zhou, and Chen Wang. "ShenShuai II Recipe Attenuates Apoptosis and Renal Fibrosis in Chronic Kidney Disease by Increasing Renal Blood Flow and Improving Oxygen Consumption." Evidence-Based Complementary and Alternative Medicine 2018 (December 13, 2018): 1–8. http://dx.doi.org/10.1155/2018/7602962.
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Background. Hypoxia plays a significant role in the progression of chronic kidney disease (CKD) and renal fibrosis. In China, Chinese herbal medicine has been widely used to treat CKD. ShenShuai II Recipe (SSR) is a commonly used prescription which has shown good results against CKD. However, the exact mechanisms of SSR are still unknown. In this study, chronic renal failure (CRF) was induced in rats by the 5/6 renal ablation/infarction (A/I) surgery; we investigated the efficacy and mechanisms of SSR on CKD in the current study. Male Sprague-Dawley (SD) rats were divided into the four groups: (1) sham operation group, (2) 5/6 (A/I) model group, (3) 5/6 (A/I) +SSR group, and (4) 5/6 (A/I) +Losartan group (5/6 (A/I) +Los). After 8 weeks of treatment, we evaluated renal blood flow (RBF) and oxygen consumption along with renal function, apoptosis, and renal fibrosis. Our results showed that SSR significantly improved RBF and reduced intrarenal oxygen consumption and apoptosis. Moreover, SSR markedly attenuated interstitial fibrosis, accompanied by decreased levels of serum creatinine (Scr), serum uric acid (UA), increased hemoglobin (HB), and evaluated glomerular filtration rates (eGFRs). These results suggest that SSR could mediate renal protection by improving intrarenal hypoxia and, furthermore, participate in the antiapoptotic effects by downregulating apoptosis markers (cleaved caspase-3 and the ratio of Bax/Bcl2) in 5/6 (A/I) model with CRF rats.
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Chan, Melody M. Y., and Yvonne M. Y. Han. "Effects of Transcranial Direct Current Stimulation (tDCS) in the Normalization of Brain Activation in Patients with Neuropsychiatric Disorders: A Systematic Review of Neurophysiological and Neuroimaging Studies." Neural Plasticity 2020 (December 23, 2020): 1–16. http://dx.doi.org/10.1155/2020/8854412.
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Background. People with neuropsychiatric disorders have been found to have abnormal brain activity, which is associated with the persistent functional impairment found in these patients. Recently, transcranial direct current stimulation (tDCS) has been shown to normalize this pathological brain activity, although the results are inconsistent. Objective. We explored whether tDCS alters and normalizes brain activity among patients with neuropsychiatric disorders. Moreover, we examined whether these changes in brain activity are clinically relevant, as evidenced by brain-behavior correlations. Methods. A systematic review was conducted according to PRISMA guidelines. Randomized controlled trials that studied the effects of tDCS on brain activity by comparing experimental and sham control groups using either electrophysiological or neuroimaging methods were included. Results. With convergent evidence from 16 neurophysiological/neuroimaging studies, active tDCS was shown to be able to induce changes in brain activation patterns in people with neuropsychiatric disorders. Importantly, anodal tDCS appeared to normalize aberrant brain activation in patients with schizophrenia and substance abuse, and the effect was selectively correlated with reaction times, task-specific accuracy performance, and some symptom severity measures. Limitations and Conclusions. Due to the inherent heterogeneity in brain activity measurements for tDCS studies among people with neuropsychiatric disorders, no meta-analysis was conducted. We recommend that future studies investigate the effect of repeated cathodal tDCS on brain activity. We suggest to clinicians that the prescription of 1-2 mA anodal stimulation for patients with schizophrenia may be a promising treatment to alleviate positive symptoms. This systematic review is registered with registration number CRD42020183608.
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Birckhead, Brandon, Sam Eberlein, Genie Alvarez, Rebecca Gale, Taylor Dupuy, Katherine Makaroff, Garth Fuller, et al. "Home-based virtual reality for chronic pain: protocol for an NIH-supported randomised-controlled trial." BMJ Open 11, no. 6 (June 2021): e050545. http://dx.doi.org/10.1136/bmjopen-2021-050545.
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IntroductionChronic pain is highly prevalent and associated with a large burden of illness; there is a pressing need for safe, home-based, non-pharmacological, interventions. Virtual reality (VR) is a digital therapeutic known to be effective for acute pain, but its role in chronic pain is not yet fully elucidated. Here we present a protocol for the National Institute of Health (NIH) Back Pain Consortium (BACPAC) VR trial that evaluates the effectiveness of three forms of VR for patients with chronic lower back pain (cLBP), a highly prevalent form of chronic pain.Methods and analysisThe NIH BACPAC VR trial will randomise 360 patients with cLBP into one of three arms, each administered through a head-mounted display: 1) skills-based VR, a program incorporating principles of cognitive behavioural therapy, mindful meditation and physiological biofeedback therapy using embedded biometric sensors; 2) distraction-based VR, a program using 360-degree immersive videos designed to distract users from pain; and 3) sham VR, a non-immersive program using two-dimensional videos within a VR headset. Research participants will be monitored for 12 weeks using a combination of patient-reported outcomes administered via REDCap (Research Electronic Data Capture), wearable sensor data collected via Fitbit Charge 4 and electronic health record data. The primary outcome will be the NIH Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference scale. Secondary outcomes will include PROMIS Anxiety, PROMIS Sleep Disturbance, opioid prescription data and Pain Catastrophizing Scale Short Form. A subgroup analysis will explore patient level predictors for VR efficacy.Ethics and disseminationEthics approval was obtained from the Institutional Review Board of Cedars-Sinai Health System in April 2020. The results will be disseminated in a peer-reviewed journal.Trial registration numberNCT04409353.
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Song, Zhenyan, Deyong Luo, Yuke Wang, Yushan Zheng, Peiying Chen, Xiaofang Xia, Chunxiang He, et al. "Neuroprotective Effect of Danggui Shaoyao San via the Mitophagy-Apoptosis Pathway in a Rat Model of Alzheimer’s Disease." Evidence-Based Complementary and Alternative Medicine 2021 (September 28, 2021): 1–11. http://dx.doi.org/10.1155/2021/3995958.
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Alzheimer’s disease (AD) is a serious neurodegenerative disease. While the main pathological characteristic of AD is widely believed to be the accumulation of amyloid-beta (Aβ) in neurons around neurofibrillary plaques, the molecular mechanism of pathological changes is not clear. Traditional Chinese medicine offers many treatments for AD. Among these, Danggui Shaoyao San (DSS) is a classic prescription. In this study, an AD model was established by injecting Aβ 1–42 into the brains of rats, which were then treated with different concentrations of Danggui Shaoyao San (sham operation; model; and Danggui Shaoyao San high-dose, medium-dose, and low-dose intervention groups). The Morris water maze test was used to assess the learning and memory abilities of the animals in each group. Nissl staining was used to detect neurons. Mitophagy was evaluated by transmission electron microscopy and immunofluorescence colocalization. Apoptosis was assessed by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay. The expression levels of autophagy- and apoptosis-related proteins were measured by western blot. Compared to the model group, the groups of AD rats administered medium and high doses of Danggui Shaoyao San showed significantly increased learning and memory abilities ( P < 0.05 ), as well as significantly increased autophagosomes in the hippocampus. Moreover, the expression of PTEN-induced kinase 1 (PINK1), Parkin, and microtubule-associated protein light chain 3 (LC3-I/LC3-II) was increased, while that of p62 was significantly decreased ( P < 0.05 ). The neuronal apoptosis rate was also significantly decreased, the Bcl-2/Bax ratio was significantly increased, and the cleaved caspase-3 protein expression was significantly decreased ( P < 0.05 ). Therefore, Danggui Shaoyao San inhibited neuronal apoptosis in AD rats via a mechanism that may be related to the activation of the PINK1-Parkin-mediated mitophagy signaling pathway.
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Liu, Xiaoyu, Jing Lin, Qing Wang, Siyao Xiao, and Ling Wang. "Prescription rules of Qingzhu Fu, Ziming Chen, and Qian Wu for threatened miscarriage based on traditional Chinese medicine inheritance auxiliary platform." Traditional Medicine and Modern Medicine 03, no. 03 (September 2020): 185–90. http://dx.doi.org/10.1142/s257590002050010x.
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Background: To explore the prescription rules of famous ancient physicians in the treatment of threatened miscarriage. Methods: Traditional Chinese Medicine (TCM) prescriptions for threatened miscarriage were screened out of Fu Ren Da Quan Liang Fang by Ziming Chen, Yi Zong Jin Jian by Qian Wu, and Fu Qing Zhu Nv Ke by Qingzhu Fu. Data were standardized and analyzed through the TCM inheritance auxiliary platform. Results: A total of 29 prescriptions for threatened miscarriage were screened. Dang Gui, E Jiao, Gan Cao, Chuan Xiong, Bai Shao were the top five frequently prescribed Chinese herbs. The common herb–herb combinations used by Ziming Chen contained E Jiao, Dang Gui, Chuan Xiong, Ai Ye, Cong Bai, and Sang Ji Sheng. Ren Shen, Gan Cao, and Bai Zhu were the common herbal groups used by Qingzhu Fu. Huang Qi, Shu Di Huang, Bai Shao, Dang Gui, and Gan Cao were one of Qian Wu’s core prescriptions, with Dang Gui and Chuan Xiong being the others. According to the analysis of four Qi, five flavors, and meridian tropism of the prescriptions, herbs with the warm nature, or with the sweet, pungent, bitter flavors topped the list of application. The top six meridian tropisms of high-frequency herbs were: liver, spleen, lung, kidney, heart, and stomach meridian. Conclusion: Based on the principle of restoring the balance within the organs and enriching Qi and blood, clinical treatment of threatened miscarriage involves invigorating the Chong and Ren channels, nourishing Yin, dispelling cold and wind, generating and activating blood, regulating and harmonizing Qi.
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Valenzuela, Trinidad, Jeff S. Coombes, Teresa Liu-Ambrose, Yorgi Mavros, Nicole Kochan, Perminder S. Sachdev, Jeffrey Hausdorff, et al. "Study protocol for the BRAIN Training Trial: a randomised controlled trial of Balance, Resistance, And INterval training on cognitive function in older adults with mild cognitive impairment." BMJ Open 12, no. 12 (December 2022): e062059. http://dx.doi.org/10.1136/bmjopen-2022-062059.
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IntroductionEpidemiological evidence suggests that both poor cardiovascular fitness and low muscle mass or strength markedly increase the rate of cognitive decline and incident dementia in older adults. Results from exercise trials for the improvement of cognition in older adults with mild cognitive impairment (MCI) have reported mixed results. This is possibly due to insufficient exercise intensities. The aim of the Balance, Resistance, And INterval (BRAIN) Training Trial is to determine the effects of two forms of exercise, high-intensity aerobic interval training (HIIT) and high-intensity power training (POWER) each compared with a sham exercise control group on cognition in older adults with MCI.Methods and analysisOne hundred and sixty community-dwelling older (≥ 60 years) people with MCI have been randomised into the trial. Interventions are delivered supervised 2–3 days per week for 12 months. The primary outcome measured at baseline, 6 and 12 months is performance on a cognitive composite score measuring the executive domain calculated from a combination of computerised (NeuroTrax) and paper-and-pencil tests. Analyses will be performed via repeated measures linear mixed models and generalised linear mixed models of baseline, 6-month and 12-month time points, adjusted for baseline values and covariates selected a priori. Mixed models will be constructed to determine the interaction of GROUP × TIME.Ethics and disseminationEthical approval was obtained from the University of Sydney (HREC Ref.2017/368), University of Queensland (HREC Ref. 2017/HE000853), University of British Columbia (H16-03309), and Vancouver Coastal Health Research Institute (V16-03309) Human Research Ethics. Dissemination will be via publications, conference presentations, newsletter articles, social media, talks to clinicians and consumers and meetings with health departments/managers.It is expected that communication of results will allow for the development of more effective evidence-based exercise prescription guidelines in this population while investigating the benefits of HIIT and POWER on subclinical markers of disease.Trial registration numberACTRN12617001440314 Australian New Zealand Clinical Trials Registry.
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Wang, Yuhan, Yanhua Jiang, Jing Hu, Ying Yang, Yanjun Liu, Haixia Liu, Zhiguo Zhang, and Yanjing Chen. "Dynamic Evolution of Cardiac Function and Glucose and Lipid Metabolism in Ovariectomized Rats and the Intervention Effect of Erxian Decoction." Evidence-Based Complementary and Alternative Medicine 2022 (December 17, 2022): 1–14. http://dx.doi.org/10.1155/2022/8090868.
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Aims. Abnormal changes in cardiac function have been reported in menopausal women, but there are few clinical studies on this topic. Erxian decoction (EXD) is a classic prescription that is widely used in the treatment of female menopausal diseases. The purpose of this study was to investigate the dynamic evolution of cardiac function and glucose and lipid metabolism in ovariectomized (OVX) rats and the intervention effect of EXD. Materials and Methods. The OVX climacteric rat model was established by bilateral ovariectomy. After successful modeling, the rats were randomly divided into four groups: the sham operation (SHAM) group (equal volumes of purified water), OVX group (equal volumes of purified water), estradiol (E2) group (1.8 × 10−4 g/kg), and EXD group (9 g/kg). Each group of rats was treated for 16 weeks. At the 4th, 8th, 12th, and 16th weeks after treatment, the cardiac function of the rats in each group was evaluated by ultrasound. The coaxial method was used to measure blood pressure (BP). Serum endothelin-1 (ET-1) and angiotensin-2 (Ang II) levels were determined by the enzyme-linked immunosorbent assay (ELISA). The strip method was used to measure fasting blood glucose (FBG). The serum total cholesterol (TC) and triglyceride (TG) levels of rats were measured with the oxidase method. Direct methods were used to measure serum high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) levels. At week 16 of dosing, serum E2 levels were determined by E2 radioimmunoassay. The myocardium and uterus of the rats in each group were stained with HE (hematoxylin-eosin). The ultrastructure of the rat myocardium was observed by electron microscopy. Results. After the 16th week of treatment, the serum E2 level decreased ( P < 0.05 ), and the uterus was atrophied in OVX rats. The cardiac ejection fraction (EF%) decreased at 4 weeks after treatment, and systolic and diastolic function decreased after 12 weeks. After the 16th week, the EF%, which reflects the “pump” function of the heart, decreased significantly ( P < 0.05 or P < 0.01 ). At the 4th, 8th, 12th, and 16th weeks of treatment, the systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean pressure (MBP) of the rats in the OVX group increased with time ( P < 0.05 or P < 0.01 ). The serum ET-1 and Ang II levels of rats in the OVX group increased ( P < 0.05 or P < 0.01 ). In the OVX group, FBG was increased ( P < 0.05 or P < 0.01 ), and blood lipids, especially LDL-C, were significantly increased ( P < 0.05 or P < 0.01 ). After the 16th week of treatment, the myocardial tissue of OVX rats showed obvious pathological changes. EXD significantly increased serum E2 levels ( P < 0.01 ), decreased ET-1 and Ang II levels ( P < 0.01 ), reduced the cardiac function risk factors BP, FBG, and blood lipids, and significantly improved cardiac function and structural changes in OVX rats ( P < 0.05 or P < 0.01 ). Conclusions. EXD can improve abnormal cardiac structure and function in OVX rats.
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Fellas, A., J. Chaitow, D. Singh-Grewal, D. Santos, M. Clapham, and A. Coda. "OP0207-HPR EFFECT OF FOOT ORTHOSES IN REDUCING PAIN IN CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS: A 12-MONTH RANDOMISED CLINICAL TRIAL." Annals of the Rheumatic Diseases 81, Suppl 1 (May 23, 2022): 136.3–136. http://dx.doi.org/10.1136/annrheumdis-2022-eular.854.
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BackgroundJuvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children and adolescents [1]. The manifestation of JIA may include joint swelling, tenderness, and painful limitation with joint movement. Only few studies have explored the effect of foot orthoses (FOs) alone in children with JIA [2,3]. These studies showed FOs can reduce pain in children with JIA, however, further research with larger sample sizes and longer follow-ups are needed [4]. Prescribing FOs on the same day of the initial assessment may promote early clinical and targeted intervention, which is the gold standard approach in paediatric rheumatology.ObjectivesThis single blinded multicentre randomised clinical trial (RCT) aims to investigate the effect of customised prefabricated FOs in reducing pain amongst children and adolescents with JIA.MethodsOverall, 66 children and adolescents with JIA presenting with foot symptoms were recruited from the Sydney Children’s Hospitals Network (Westmead and Randwick) and John Hunter Children’s Hospital (Newcastle). The primary outcome measure was pain with a minimal clinical significance of 8mm on the visual analogue scale (VAS). Participants were randomly allocated to receive either customised prefabricated or sham FOs. The trial intervention was a low-density Slimflex Simple device that was customised at chair-side. The control (sham) device was made of 2mm flat leather board with no corrective modifications. Standardised tests such as the Foot Posture Index, navicular drift and drop were used to identify biomechanical abnormalities. The FOs were worn for a total of 12 months, with data collected at baseline, 4 weeks, 3, 6 months and 12 months.ResultsReduction in self-reported pain was statistically and clinically significant at 4-weeks (p=0.018, -14.92 [-27.30, -2.55]) and 3 months (p=<0.001, -28.93 [-40.90, -16.96]) post intervention in favour of the trial group. The 6- and 12-month follow-ups were not statistically or clinically significant. Parent reported pain was statistically and clinically significant at the 3-month (p=<0.001, -21.92 [-33.16, -10.67]) in the reduction of pain in favour of the trial group. However, parent reported pain was not statistically significant at the 4-week, 6- and 12- month follow-ups. These results are similar to child reported pain with a p-value of less than 0.001 and average coefficients twice that of the clinical significance cut-off for VAS pain in paediatric rheumatology. The trial intervention was safe and tolerated well by participants with high compliance and adherence rates.ConclusionResults of this clinical trial indicate customised preformed FOs can be effective in reducing pain and in children with JIA experiencing foot and ankle symptoms. Significant clinical effects appear to be within the first 3-months of intervention prescription and reduce beyond 6 months. Overall, this podiatric intervention was safe, inexpensive, well tolerated and it can be easily implemented as part of the multidisciplinary paediatric rheumatology care.References[1]Ravelli A, Martini A. Juvenile idiopathic arthritis. Lancet. 2007;369:767–78.[2]Powell M, Seid M, Szer IS. Efficacy of custom foot orthotics in improving pain and functional status in children with juvenile idiopathic arthritis: a randomized trial. J Rheumatol 2005;32:943–50.[3]Coda A, Fowlie PW, Davidson JE et al. Foot orthoses in children with juvenile idiopathic arthritis: a randomised controlled trial. Arch Dis Child 2014;99:649–51.[4]Fellas A, Coda A, Hawke F. Physical and mechanical therapies for lower-limb problems in juvenile idiopathic arthritis: a systematic review with meta-analysis. Journal of the American Podiatric Medical Association. 2017 Sep;107(5):399-412.AcknowledgementsWe would like to acknowledge all parents and children for their precious time.Disclosure of InterestsNone declared
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Tobbell, D. A. "Medicating Modern America: Prescription Drugs in History." Social History of Medicine 21, no. 3 (October 13, 2008): 591–93. http://dx.doi.org/10.1093/shm/hkn091.
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Anderson, Stuart. "Profits Before People? Ethical Standards and the Marketing of Prescription Drugs." Social History of Medicine 20, no. 2 (August 1, 2007): 403–5. http://dx.doi.org/10.1093/shm/hkm051.
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Kamdar, Parth, Christopher Antonacci, Katherine Vadasdi, R. Greene, Francis Alberta, Paul Sethi, and Nicole Liddy. "Poster 223: Evidence-Based Opioid Prescribing Guidelines Following Anterior Cruciate Ligament Reconstruction (ACLR)." Orthopaedic Journal of Sports Medicine 10, no. 7_suppl5 (July 1, 2022): 2325967121S0078. http://dx.doi.org/10.1177/2325967121s00784.
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Objectives: Opioid prescriptions following anterior cruciate ligament reconstruction (ACLR) vary substantially.1-3 Expert panel guidelines recommend up to 50 pills for ACLR with many surgeons refilling 40 or more tablets.1,3 The CDC warns that a five-day supply is sufficient to develop opiate dependence.4 Current recommendations are based on consensus rather than evidence and place a vulnerable population at risk for opiate misuse.2,3 Orthopaedic surgeons do not possess evidence driven regimens for opioid prescriptions following ACLR.5,6 The purpose of this study was to develop evidence-based prescription guidelines for ACLR. We hypothesized that patients would require fewer opioids than traditional guidelines suggest with a high rate of patient satisfaction. 1. Beck, J.J., et al., Prospective Study of Acute Opioid Use After Adolescent Anterior Cruciate Ligament Reconstruction Shows No Effect From Patient- or Surgical-Related Factors. J Am Acad Orthop Surg, 2020. 28(7): p. 293-300. 2. Wyles, C.C., et al., Implementation of Procedure-Specific Opioid Guidelines: A Readily Employable Strategy to Improve Consistency and Decrease Excessive Prescribing Following Orthopaedic Surgery. JB JS Open Access, 2020. 5(1): p. e0050. 3. Stepan, J.G., et al., Development of an Institutional Opioid Prescriber Education Program and Opioid-Prescribing Guidelines: Impact on Prescribing Practices. J Bone Joint Surg Am, 2019. 101(1): p. 5-13. 4. Shah A HC, Martin BC. Characteristics of Initial Prescription Episodes and Likelihood of Long-Term Opioid Use — United States, 2006–2015. MMWR Morb Mortal Wkly Rep 2017:265-269. 5. Reider, B. Opioid Epidemic. Am J Sports Med, 2019. 44(5): p. 1039-1042. 6. Morris BJ, Mir HR. The opioid epidemic: Impact on orthopaedic surgery. J Am Acad Orthop Surg 2015;23: 267-271. Methods: This multicenter prospective study enrolled 46 patients undergoing ACLR. Subject demographics and opioid prescriptions were recorded at the time of enrollment. All patients were given instructions and education on opiate use. All patients followed the same perioperative, multimodal analgesic regimen (Table 1). Following surgery, patients were given postoperative “Pain Journals” to document visual analog scale (VAS) pain scores and to track their daily opioid consumption for the first 7 postoperative days (PODs) and on postoperative visit (POV) at 14 days. No changes were made to existing prescribing habits, postoperative physical rehabilitation, or surgical methodology. Results: 35 patients were included in this analysis. Mean subject age was 39 years old. 46% of patients were male; 54% of patients were female. Patients were prescribed a median of 15 oxycodone 5 mg pills and consumed a median of 2 pills postoperatively. Mean postoperative opioid consumption was 5 pills (range 0 to 31 pills). 42% of patients consumed 0 opioid pills; 77% of patients consumed ≤ 5 opioid pills; 73% of patients discontinued opioid use after POD 2 (Figure 1). Patients reported a mean daily VAS value of 2.5 of 10; mean satisfaction with pain management was high at 4.16/5 on a Likert satisfaction score. Overall, patients consumed a mean 28% of their opioid prescriptions, leaving 230 opioid pills not consumed. Conclusions: This study suggests that current expert panels may be recommending an unrequired volume of opioids. As the third largest prescriber of opiate medication, orthopedic surgeons are charged with reducing the risk of opiate dependence, particularly in the ACLR vulnerable population.6 Based on our findings, patients only require 15 Oxycodone 5mg tablets following ACLR. Despite this lower volume prescription, mean pain scores remained below 3/10, patient satisfaction with pain control remained high, and 72% of opiate medication prescribed was not used. [Table: see text]
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Kumar, Kavitha Ashok, Mohammad Rafiq Bin Baderu Khisam, and Ashok Kumar Jeppu. "Prescription Pattern of Antibiotics for Upper Respiratory Tract Infection in Shah Alam, Malaysia." Indian Journal of Public Health Research & Development 10, no. 2 (2019): 277. http://dx.doi.org/10.5958/0976-5506.2019.00301.2.
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Kumar, Kavitha Ashok, Mohammad Rafiq Bin BaderuKhisam, and Ashok Kumar Jeppu. "Prescription Pattern of Antibiotics for Upper Respiratory Tract Infection in Shah Alam, Malaysia." Indian Journal of Public Health Research & Development 10, no. 12 (December 1, 2019): 1759. http://dx.doi.org/10.37506/v10/i12/2019/ijphrd/192119.
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Chang, Hui-Chiu, Sheng-l. Lue, Chin Hsu, Hseng-Kuang Hsu, Ching-Feng Weng, and John Yuh-Lin Yu. "Effects of Chinese Herbal Prescriptions on Copulatory Activity in Aged Male Rats: A Preliminary Study." American Journal of Chinese Medicine 26, no. 01 (January 1998): 83–90. http://dx.doi.org/10.1142/s0192415x98000117.
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Four herbal prescription medicines, Chi-Pao-Mei-Jan-Tan, Gui-Fu-Ba-Wei-Wan, Huan-Shao-Tan; and San Tsai-Feng-Sui-Tan, were tested for their effects on sexual behavior in aged rats. Crude liquid extracts of these herbs were administered to the rats daily through oral tubing for 14 days. All four herbal prescriptions showed some effects in restoration of mount and intromission behaviors, but there was no effect on restoration of ejaculation in 26 month old rats that had exhibited no copulatory activity (no mount, intromission and ejaculation) previously. The effects of Chi-Pao-Mei-Jan-Tan were further tested in 26 month old rats with low mount and intromission activities but without ejaculation behavior, and in 15 month old rats (middle-age group) that showed normal mount and intrornission behavior but no ejaculation activity. Chi-Pao-Mei-Jan-Tan was effective in improving the frequency of both mount and intromission, but failed to restore the ejaculation activity of the old rats with low mount and intromission behaviors. It was, however, very effective in restoration of ejaculation activity in middle-aged rats that exhibited normal mount and intromission behaviors. Serum testosterone (T) levels of Chi-Pao-Mei-Jan- Tan in tested old and middle-aged rats were determined by radioimmunoassay, and showed no difference before and after treatment. Our findings demonstrated that the four herbal prescriptions had some effects in restoration of mount and intromission behaviors, but not ejaculation activity in old rats, and that Chi-Pao-Mei-Jan-Tan was very effective in restoration of ejaculation activity in middle-aged rats. The promotional effect of Chi-Pao-Mei-Jan-Tan on copulatory behavior was not correlated with serum T levels.
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Rosenthal, Patrice, Stephen Hill, and Riccardo Peccei. "Checking Out Service: Evaluating Excellence, HRM and TQM in Retailing." Work, Employment and Society 11, no. 3 (September 1997): 481–503. http://dx.doi.org/10.1177/0950017097113005.
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We evaluate a number of the claims made in the debate between the prescriptive and critical literature that surrounds `excellence', with a particular focus on human resource and quality management. The critical literature contains two positions, broadly a traditional control perspective and the other concerned with the structuring of meaning. The empirical basis of the paper is an investigation of an HRM and quality initiative in a leading supermarket company. The initiative embodies many of the prescriptions of the gurus of excellence. We present both qualitative and quantitative data collected from shopfloor and managerial staff. Our findings lend little support to the traditional criticism that, if management objectives are realised, they are achieved through some combination of sham empowerment, work intensification and increased surveillance. Our evidence lends more support to the optimistic view that modern techniques of quality and human resource management can benefit employees. We suggest that the alternative concern with the way meanings are constructed has more plausibility, because the new managerial discourse of quality has affected the attitudes of a significant number of employees towards customer service. However, there was considerable variation in how employees received the programme's message and thus its effects are by no means uniform. Moreover, we encounter an unanticipated and previously unremarked consequence of managerial discourses, that employees use these as resources in their struggles with managers in order to bring managers into line with workforce expectations.
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Cutler, Kristin, and Joseph Kremer. "Safety, Generous Doctors, and Enabling Parents: A Perfect Recipe of Justifications for College Students’ Nonmedical Use of Prescription Painkillers." Journal of Drug Issues 47, no. 4 (June 6, 2017): 587–605. http://dx.doi.org/10.1177/0022042617710953.
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National data indicate that prescription painkillers are the second most commonly misused prescription drug on college campuses. Although much research has focused on the motivations given for the nonmedical use of these drugs, few studies explore justifications for use. This article fills that gap by explicating the justifications college students incite to defend their nonmedical use of these drugs. Drawing on semistructured interviews with students ( N = 76) from a large public northwestern university, inductive analysis uncovered social learning theories of crime, more specifically Sykes and Matza’s neutralization theory, as helping to inform students’ justifications for use. These justifications were combined to form two broad justification categories: “the safety factor” and “authoritative enabling.” Given that justifications helped students to resolve any guilt, shame, or stigma associated with their deviant use of prescription painkillers, it is important that future research continue to explore and disentangle motivations from justifications.
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Shah, Nirmish, Christian Douglas, Nancy Crego, Emily Bonnabeau, Marian Earls, Kern Eason, Elizabeth Merwin, and Paula Tanabe. "Hydroxyurea Prescription Fills and Adherence, Among Pediatric and Adult Medicaid Eligible Patients with Sickle Cell Disease in North Carolina." Blood 134, Supplement_1 (November 13, 2019): 3391. http://dx.doi.org/10.1182/blood-2019-124442.
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Introduction: Sickle cell disease (SCD) is a complex disease for which pain is the hallmark. Hydroxyurea (HU) is the standard of care for treatment for most patients with SCD and reduces the frequency of pain episodes, acute chest syndrome, need for red blood cell transfusions, hospitalizations and has been shown to improve mortality. Despite National Heart Lung and Blood Institute (NHLBI) recommendations for the use of HU beginning at 9 months of age, adherence has been historically low. We aimed to: 1) describe HU prescription fills and adherence for persons with SCD enrolled in Medicaid during a 12-month period in North Carolina (NC); and 2) determine factors that may predict good adherence. Methods: Medicaid claims were examined from data obtained from Community Care of North Carolina (CCNC) for patients with a diagnosis of SCD (ICD 9 CM codes: 282.6x, ICD 10 CM codes: D57.0x, D57.1, D57.2x, D57.4x, D57.8x) between March 1, 2016 and February 28, 2017. HU claims were identified using the drug name. Only those enrolled in Medicaid for 12 months were included in this analysis. The number of HU prescriptions filled per enrollee by age group was determined by summing the number of filled HU prescriptions over the study period for each eligible enrollee. The number of HU days supplied is the sum of the days of supply on the prescription (e.g. 30-day supply) in a 12-month period per person. The duration of HU treatment days was measured as the number of days between the date of the first HU prescription filled and the last day of the study period. The number of days between breaks in treatment is the sum of days with no HU supplied, divided by the number of gaps (missing next HU prescription fill) per person. HU adherence was categorized into one of the followings: 1) Good - if number of days supplied is ≥80% of duration of HU treatment; 2) Fair or Moderate - if number of days supplied is 60-79% of duration of HU treatment; 3) Poor - if number of days supplied is < 60% of duration of HU treatment. Logistic regression was used to evaluate HU treatment adherence (good versus fair or poor). The model was conditioned on age, gender, participant residence (metro, non-metro adjacent to metro and non-metro non-adjacent to metro), co-management (at least one PCP and one hematologist visit/patient during the study period) and months enrolled in CCNC. Results: A total of 2,790 patients with Medicaid claims data were reviewed, with 649 patients meeting inclusion criteria (at least one HU prescription and 12 months enrollment in Medicaid). The participants in the sample were majority female (51.77%), lived in metropolitan areas (78.12%) and had a mean age of 16.49 years old (SD=11.49) A third of the sample (32.20%) had at least 1 HU prescription during the study period (Table 1). Those who were 1-9 years old had the highest median number of days supplied (221; range 21-750), the least median days between breaks in HU treatment (14.20; range 0-318), and the longest duration of HU treatment days (median 340; range 0-364). Those who were 18-30 years old had the lowest number of median days supplied (110; range 4-366) and the most median days between treatment (49.3; range 0-337). The 1-9 year olds also had the highest number of patients classified as good HU adherence (47.50%) and conversely the lowest classified as poor HU adherence (37.50%). In contrast, the 18-30 year old age group had the lowest good HU adherence (18.03%) and the highest poor HU adherence (69.40%) in the sample. The 31-45 year old age groups had the next lowest good HU adherence (20.93%) and next highest poor HU adherence (60.47%). Good HU adherence was most influenced by participant age. Prediction by co-management was minimal (Figure 1). Gender, residency and number of months enrolled in CCNC had little influence on HU adherence. Conclusions: Although recommended for most patients, HU was prescribed for less than one third of all patients with Medicaid in NC. Pediatric patients had the highest rate of HU prescription (40-46%) and patients over the age of 30 had the lowest (11-12%). In addition, of those prescribed HU, most patients were not classified as having good adherence. Importantly, poor HU adherence was most prevalent in the transition age group (18-30 year old), supporting the need for increased focus during the move from pediatric to adult care. Efforts should continue to explore methods that improve adherence including provider education and innovative patient strategies such as mHealth. Disclosures Shah: Alexion: Speakers Bureau; GBT: Research Funding; Novartis: Consultancy, Research Funding, Speakers Bureau. Tanabe:NIH: Research Funding; AHRQ: Research Funding.
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Ibrahim, Nuri. "Nursi the rapeutic prescription for the diseases of the Islamic nation through the Shami sermon." Academic Journal of Nawroz University 7, no. 1 (2018): 211–17. http://dx.doi.org/10.25007/ajnu.v7n1a176.
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Malleck, D. "Jeremy A Greene and Elizabeth Siegel Watkins (eds), Prescribed: Writing, Filling, Using and Abusing the Prescription in Modern America." Social History of Medicine 26, no. 3 (April 25, 2013): 593–94. http://dx.doi.org/10.1093/shm/hkt029.
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Kolb, MS, Elizabeth, and Mark Rueth, PharmD. "Patient satisfaction with clinic-based medication pick up: Addressing pharmacy-level challenges to buprenorphine access." Journal of Opioid Management 17, no. 7 (August 1, 2021): 77–86. http://dx.doi.org/10.5055/jom.2021.0645.
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Introduction: Pharmacy-level challenges that exist for patients when seeking to fill buprenorphine prescriptions at traditional retail pharmacies can result in a less than optimal treatment experience. High patient satisfaction with treatment for opioid use disorder (OUD), which for oral buprenorphine treatment includes the necessary step of obtaining medication after being prescribed, is associated with positive health outcomes and, therefore, is of great clinical interest. The objective of this study was to examine patient satisfaction when participating in a pharmacy program that coordinated buprenorphine delivery and provision to patients at office visits instead of requiring patients to fill their prescriptions at local pharmacies.Methods: We conducted a voluntary and anonymous survey to assess patient satisfaction when the need to seek a retail pharmacy to fill buprenorphine prescriptions was alleviated. The survey was completed by 714 patients prescribed buprenorphine for OUD treated at 15 office-based opioid treatment clinics that integrated the clinic-based pharmacy program as an extension of their treatment services. The survey consisted of 16 questions evaluating satisfaction with the pharmacy program and prior retail pharmacy experience.Results: Majority of patient respondents reported high levels of satisfaction with the pharmacy program. Specifically, 97.6 percent (n = 697) of respondents noted feeling respected and/or that the pharmacy staff cares about their wellbeing, 91.7 percent (n = 655) of respondents reported that they are more likely to make their treatment appointments and/or stick to their treatment plan when the physical need to seek a pharmacy to fill their prescription was alleviated. The survey resulted in an 83.8 Net Promoter Score, further supporting a high patient satisfaction. Patient responses regarding how the program impacted their recovery illustrated common themes of more convenient, more private, judgment free, quicker, and stress free. The survey responses also validated previously reported pharmacy-level barriers for patients with OUD that the program sought to alleviate. Transportation challenges and/or undue time spent obtaining medication were indicated by 77.6 percent (n = 528) of respondents, 56.8 percent (n = 386) of respondents experienced feelings of stigma or shame at retail pharmacies was experienced by 56.8% (n = 386) of respondents, and pharmacies not reliably stocking their medication was indicated by 37.1 percent (n = 252) of respondents.Conclusions: The survey findings demonstrate that patients were highly satisfied with the provision of pharmacy-dispensed buprenorphine at their treatment visit in place of having to seek to fill prescriptions at retail pharmacies. Responses indicated the pharmacy program may also be a motivating factor for patients to attend treatment appointments. Continuing to develop and research strategies that alleviate physical barriers to buprenorphine access and result in high patient satisfaction, like this clinic-based pharmacy program studied, have meaningful implications for both patients and treatment providers.
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FUKUTA, Yoshihiro. "The Role of Roasted Glycyrrhiza Root in the Main Prescriptions for Shoinbyo (shao yin bing)." Kampo Medicine 57, no. 6 (2006): 769–79. http://dx.doi.org/10.3937/kampomed.57.769.
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Righolt, Christiaan H., Karla Willows, Erich V. Kliewer, and Salaheddin M. Mahmud. "Incidence of anogenital warts after the introduction of the quadrivalent HPV vaccine program in Manitoba, Canada." PLOS ONE 17, no. 4 (April 26, 2022): e0267646. http://dx.doi.org/10.1371/journal.pone.0267646.
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Background The incidence of anogenital warts (AGW) decreased after the introduction of the quadrivalent human papillomavirus (qHPV) vaccine in multiple jurisdictions. We studied how comparing AGW incidence rates with different outcomes affects the interpretation of the qHPV vaccination program. To do this, we replicated multiple study designs within a single jurisdiction (Manitoba). Methods We measured the incidence rates of AGW, AGW-related prescriptions, chlamydia, and gonorrhea (the latter two as sham outcomes) between 2001 and 2017 using several clinical and administrative health databases from Manitoba. We then used incidence rate ratios (IRRs) to compare, for each outcome, the rate for the 1997–1998 birth cohort (the first cohorts eligible for the publicly funded qHPV vaccination program) and the older 1995–1996 birth cohort. Results AGW incidence in Manitoba dropped 72% (95% confidence interval 54–83%) among 16–18 year-old girls and 51% (14–72%) among boys after the introduction of the female-only qHPV vaccination program. Trends in AGW-related prescriptions were different from trends in AGW diagnoses as these prescriptions peaked shortly after the introduction of the publicly funded qHPV vaccine program. Chlamydia and gonorrhea incidence rates also decreased 12% (5–18%) and 16% (-1-30%), respectively, for 16–18 year-old girls. Conclusions The publicly funded school-based qHPV vaccine program reduced AGW incidence in Manitoba by three-quarters in young females. AGW-related prescriptions are a poor proxy for medically attended AGW after the introduction of the publicly funded qHPV vaccination program. Different sexual habits in adolescents are, at most, responsible for a small portion of the reduction in AGW incidence.
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Righolt, Christiaan H., Karla Willows, Erich V. Kliewer, and Salaheddin M. Mahmud. "Incidence of anogenital warts after the introduction of the quadrivalent HPV vaccine program in Manitoba, Canada." PLOS ONE 17, no. 4 (April 26, 2022): e0267646. http://dx.doi.org/10.1371/journal.pone.0267646.
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Background The incidence of anogenital warts (AGW) decreased after the introduction of the quadrivalent human papillomavirus (qHPV) vaccine in multiple jurisdictions. We studied how comparing AGW incidence rates with different outcomes affects the interpretation of the qHPV vaccination program. To do this, we replicated multiple study designs within a single jurisdiction (Manitoba). Methods We measured the incidence rates of AGW, AGW-related prescriptions, chlamydia, and gonorrhea (the latter two as sham outcomes) between 2001 and 2017 using several clinical and administrative health databases from Manitoba. We then used incidence rate ratios (IRRs) to compare, for each outcome, the rate for the 1997–1998 birth cohort (the first cohorts eligible for the publicly funded qHPV vaccination program) and the older 1995–1996 birth cohort. Results AGW incidence in Manitoba dropped 72% (95% confidence interval 54–83%) among 16–18 year-old girls and 51% (14–72%) among boys after the introduction of the female-only qHPV vaccination program. Trends in AGW-related prescriptions were different from trends in AGW diagnoses as these prescriptions peaked shortly after the introduction of the publicly funded qHPV vaccine program. Chlamydia and gonorrhea incidence rates also decreased 12% (5–18%) and 16% (-1-30%), respectively, for 16–18 year-old girls. Conclusions The publicly funded school-based qHPV vaccine program reduced AGW incidence in Manitoba by three-quarters in young females. AGW-related prescriptions are a poor proxy for medically attended AGW after the introduction of the publicly funded qHPV vaccination program. Different sexual habits in adolescents are, at most, responsible for a small portion of the reduction in AGW incidence.
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Gamble, Vanessa Northington. "Laurie B. Green, John McKiernan-González and Martin Summers, (eds),Precarious Prescriptions: Contested Histories of Race and Health in North America." Social History of Medicine 28, no. 3 (June 21, 2015): 652–54. http://dx.doi.org/10.1093/shm/hkv051.
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Weinreich, Spencer J. "Roy Porter Student Prize Essay How (Not) to Survive a Plague: The Theology of Fleeing Disease in Sixteenth-century England." Social History of Medicine 33, no. 2 (November 27, 2018): 355–76. http://dx.doi.org/10.1093/shm/hky102.
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Abstract Early modern medicine favoured flight as the best prophylactic against epidemic disease. Theologically, however, flight savoured of an attempt to defy divine providence, or a dereliction of Christian charity, while staying could seem an act of presumption or recklessness. This essay studies six theologians whose writings on the issue circulated in sixteenth-century England. Long dismissed as inconclusive and derivative, these ‘flight theologies’ can be better understood as products of theological principle and communal experience, whose combined influence precluded definitive prescriptions. Instead, authors marshalled the rhetoric of ‘conscience’ to displace the decision back onto their readers, while retaining interpretive authority over the key factors of Scripture and personal obligations. Flight theology thus seeks less to solve a practical problem, than to produce a particular kind of political subjectivity, bound to the community and predicated on persuasion. In so doing, the discourse fuelled the emergence of an early modern English public sphere.
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Hsu, C. S., J. K. Yang, and L. L. Yang. "Effect of “Dang-Qui-Shao-Yao-San” a Chinese medicinal prescription for dysmenorrhea on uterus contractility in vitro." Phytomedicine 13, no. 1-2 (January 2006): 94–100. http://dx.doi.org/10.1016/j.phymed.2004.06.016.
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Watts, Rob. "John Braithwaite and Crime, Shame and Reintegration: Some Reflections on Theory and Criminology." Australian & New Zealand Journal of Criminology 29, no. 2 (August 1996): 121–41. http://dx.doi.org/10.1177/000486589602900203.
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John Braithwaite's ‘republican theory of criminology’ (1989) claims to offer a new general theory of crime, an account of ‘the good society’ and a set of policy prescriptions for effective crime control. Along the way he has spelt out a moral theory grounded in communitarianism, and refined his own version of a ‘progressive’ politics. This paper examines two central aspects of Braithwaite's work. Given Braithwaite's claim to say why ‘some kinds of individuals and some kinds of societies exhibit more crime’, the paper suggests his answers to this question and the adequacy of his notion of good social science are severely wanting. Braithwaite's claim to be offering a theory of the moral shares with the Durkheimian tradition he draws on, a refusal of the moral. The contemporary praise accorded Braithwaite's work is a sign both of intellectual desperation and of a pervasive nostalgia for a return to ‘community’ exemplified in the work of communitarians like Macintyre (1981) and Bellah (1985).
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Bao, Xiao-Yi, Li-Hui Deng, Zi-Jun Huang, Abdirizak S. Daror, Zi-Hao Wang, Wang-Jun Jin, Zhuang Zhuang, Qiang Tong, Guo-Qing Zheng, and Yan Wang. "Buyang Huanwu Decoction Enhances Revascularization via Akt/GSK3β/NRF2 Pathway in Diabetic Hindlimb Ischemia." Oxidative Medicine and Cellular Longevity 2021 (December 3, 2021): 1–15. http://dx.doi.org/10.1155/2021/1470829.
Full textAbstract:
Background. Peripheral arterial disease (PAD) is a typical disease of atherosclerosis, most commonly influencing the lower extremities. In patients with PAD, revascularization remains a preferred treatment strategy. Buyang Huanwu decoction (BHD) is a popular Chinese herbal prescription which has showed effects of cardiovascular protection through conducting antioxidant, antiapoptotic, and anti-inflammatory effects. Here, we intend to study the effect of BHD on promoting revascularization via the Akt/GSK3β/NRF2 pathway in diabetic hindlimb ischemia (HLI) model of mice. Materials and Methods. All db/db mice ( n = 60 ) were randomly divided into 6 groups by table of random number. (1) Sham group ( N = 10 ): 7-0 suture thread passed through the underneath of the femoral artery and vein without occlusion. The remaining 5 groups were treated differently on the basis of the HLI (the femoral artery and vein from the inguinal ligament to the knee joint were transected and the vascular stump was ligated with 7-0 silk sutures) model: (2) HLI+NS group ( N = 15 ): 0.2 ml NS was gavaged daily for 3 days before modeling and 14 days after occlusion; (3) HLI+BHD group ( N = 15 ): 0.2 ml BHD (20 g/kg/day) was gavaged daily for 3 days before modeling and 14 days after occlusion; (4) HLI+BHD+sh-NC group ( N = 8 ): local injection of adenovirus vector carrying the nonsense shRNA (Ad-GFP) in the hindlimbs of mice before treatment; (5) HLI+BHD+sh-NRF2 group ( N = 8 ): knockdown of NRF2 in the hindlimbs of mice by local intramuscular injection of adenovirus vector carrying NRF2 shRNA (Ad-NRF2-shRNA) before treatment; and (6) HLI+BHD+LY294002 group ( N = 4 ): intravenous injection of LY294002 (1.5 mg/kg) once a day for 14 days on the basis of the HLI+BHD group. Laser Doppler examination, vascular cast, and immunofluorescence staining were applied to detect the revascularization of lower limbs in mice. Western blot analysis was used to detect the expression of vascular endothelial growth factor (VEGF), interleukin-1beta (IL-1β), interleukin-6 (IL-6), tumor necrosis factor- (TNF-) α, heme oxygenase-1 (HO-1), NAD(P)H dehydrogenase quinone-1 (NQO-1), catalase (CAT), glyceraldehyde-3-phosphate dehydrogenase (GAPDH), phosphorylated protein kinase B (p-AKT), and phosphorylated glycogen synthase kinase-3 beta (p-GSK3β). HE staining was used to assess the level of muscle tissue damage and inflammation in the lower extremities. Local multipoint injection of Ad-NRF2-shRNA was used to knock down NRF2, and qPCR was applied to detect the mRNA level of NRF2. The blood glucose, triglyceride, cholesterol, MDA, and SOD levels of mice were tested using corresponding kits. The SPSS 20.0 software and GraphPad Prism 6.05 were used to do all statistics. Values of P < 0.05 were considered as statistically significant. Results and Conclusions. BHD could enhance the revascularization of lower limbs in HLI mice, while BHD has no effect on blood glucose and lipid level in db/db mice ( P > 0.05 ). BHD could elevate the protein expression of VEGF, HO-1, NQO-1, and CAT ( P < 0.05 ) and decrease the expression of IL-1β, IL-6, and TNF-α ( P < 0.05 ) in HLI mice. Meanwhile, BHD could activate NRF2 and promote the phosphorylation of AKT/GSK3β during revascularization ( P < 0.05 ). In contrast, knockdown of NRF2 impaired the protective effects of BHD on HLI ( P < 0.05 ). LY294002 inhibited the upregulation of NRF2 activated by BHD through inhibiting the phosphorylation of the AKT/GSK3β pathway ( P < 0.05 ). The present study demonstrated that BHD could promote revascularization on db/db mice with HLI through targeting antioxidation, anti-inflammation, and angiogenesis via the AKT/GSK3β/NRF2 pathway.